New information has surfaced about Big Pharma’s relentless campaign to sell the public on prescription, opioid painkillers─powerful, addictive drugs whose wide availability and abuse now has become a killer scourge that claims almost 80 Americans’ lives each day.
These latest news reports, especially focusing on OxyContin, one of the most potent and abused painkillers, also paint an ugly picture of doctors as easy marks, all too willing to risk their patients’ well-being in exchange for doughnuts, lunches, and cheap gift certificates at book stores.
Kudos first to Stat, the online health information site, for following up the commendable efforts by West Virginia officials to hold two drug companies, Purdue Pharma and Abbott Laboratories, accountable for millions of dollars in harms that abuse of OxyContin caused after the small, poor state was flooded with the prescription painkiller. Neither Purdue nor Abbott admitted to any wrongdoing in settling a lawsuit with West Virginia, which asserted that overzealous marketing by the two companies had contributed to the state’s painkiller epidemic. Purdue agreed to pay $10 million to the state in 2004 to settle the suit.
Stat, as part of its investigation of the nation’s opioid abuse crisis, asked a state judge in West Virginia to unseal case records─a request since granted. It has revealed how extensive Abbott’s role was in selling OxyContin. The Los Angeles Times has done some outstanding investigative work describing Purdue’s unseemly hawking of OxyContin.
Abbott: the big sell, less public scrutiny
But Abbott for a half dozen years in the mid-Nineties and early-2000s was a bigger pharma firm, with more sales resources, and a deal not disclosed until now with Purdue. The two firms partnered to push OxyContin, Stat says. Purdue found such advantage in this arrangement with its powerful partner that it provided legal indemnity in case any issues arose with OxyContin─and that’s why Abbott’s role in spreading the potent painkiller hasn’t drawn public attention — or should the word be ignominy?
The Stat story details how Abbott executives pressured hundreds in their sales staff to flog OxyContin to anesthesiologists, surgeons, emergency room doctors, and pain management experts. Abbott was strong in places where Purdue might not be, including in hospitals and surgical centers. Stat reports that Abbott created ambitious internal campaigns with trips, cash awards, and bonuses as sales incentives. The Abbott hype to its employees was organized around a silly playing card theme, with a company sales vice president dubbing himself the King of Pain.
Based on court records, Abbott sales staff also were told to use dubious information to sell OxyContin─data not supported by science and similar to misleading materials that Purdue would be penalized for, paying hundreds of millions of dollars in fines for misleading consumers.
Of course doctors, a key target of this effort, appeared to be goofballs needing little persuasion: some, the Stat story says, needed only boxes of doughnuts or inexpensive lunches or cheap gift certificates given in visits to local bookstores before they became OxyContin enthusiasts. Purdue paid Abbott hundreds of millions of dollars from the more than $1 billion in revenue OxyContin threw off; Abbott continues to collect some payments from Purdue.
By the time Abbott changed its business model, split itself in two, and broke off its deal with Purdue, Stat notes, the nation was awash with OxyContin and other prescription painkillers. The abuse had become widespread, and now as the news site Vox points out:
In 2014, more Americans died of drug overdoses than any other year on record — more than 47,000 deaths in just one year. That’s higher than the nearly 34,000 who died in car crashes, the almost 34,000 who died from gun violence, and the more than 43,000 who died due to HIV/AIDS during that epidemic’s peak in 1995.
The D.C. ‘echo chamber’
So where were the health care wonks, regulators, policy-makers, and politicians as Big Pharma was setting the house on fire? The Associated Press has provided another critical piece of the puzzle about the opioid epidemic in its investigation of the “echo chamber” that the industry and its allies spent heavily to build up. It worked so key players heard only the most positive reports about opioids─and the supposed giant, excruciating challenge these drugs answered.
The AP and the nonprofit Center for Public Integrity found that “a little known group called the Pain Care Forum”─ a “loose coalition of drugmakers, trade groups and dozens of nonprofits supported by industry funding”─spent extravagantly and lobbied extensively on behalf of Big Pharma’s prescription pain-killing products. As the news service found:
From 2006 through 2015, participants in the Pain Care Forum spent over $740 million lobbying in the nation’s capital and in all 50 statehouses on an array of issues, including opioid-related measures … . The same organizations reinforced their influence with more than $140 million doled out to political campaigns, including more than $75 million alone to federal candidates, political action committees and parties. That combined spending on lobbying and campaigns amounts to more than 200 times the $4 million spent during the same period by the handful of groups that work for restrictions on painkillers. Meanwhile, opioid sales reached $9.6 billion last year. ….
Besides doling out political cash, the group issued studies, talking points, and other persuasive materials─all purporting to be patient-focused while they also pushed the Big Pharma perspective.
The group conducted events, inviting influential leaders, and it had access to top politicians, including, the AP notes: U.S. Rep. Mike Rogers, a Michigan Republican who has left office but received at least $310,000 in contributions from forum groups from 2006 to 2015 (those sums went to his campaign and to a leadership account that he could use to donate to his peers); Sen. Orrin Hatch, R-Utah, who got $360,00 from the forum; and former Sen. Chris Dodd, D-Conn., who received $190,000. Hatch and Dodd introduced a Senate version of a Rogers bill favorable to Big Pharma, calling on federal officials to study pain and its remedies.
The AP investigation also details how the forum and its allies muscled regulators and policy-makers, especially at the federal Food and Drug Administration; the federal Centers for Disease Control and Prevention, in Atlanta and outside the Beltway, played a key role in watchdogs breaking free of the group’s sway to warn about the prescription drug abuse calamity.
Although it’s great to see media organizations play their critical First Amendment roles to investigate this and other issues, it is deeply disturbing to see how big cash and insidious, persistent campaigning can exert such fatal influence in American life as has happened with prescription painkillers. It’s worth emphasizing that we all have our duties to preserve our democracy as we can. Lawsuits, as the Stat investigation shows, can pry loose vital information the public needs to know. And, for patients who were and continue to be harmed by reckless hyping of dangerous drugs, lawsuits may provide a measure of justice and critical economic assistance.